Acute phase factors associated with the course of depression during the first 18 months after first-ever stroke

Abstract

Purpose: The aim of this study was to describe the course of post-stroke depression (PSD) during the first 18 months after first-ever stroke and to examine differences in the course of depressive symptoms in relation to patient demographic and clinical characteristics in the acute phase. Methods: As part of a longitudinal cohort study, data were collected from medical records and in face-to-face interviews using standardized questionnaires within 15 days after stroke and 6, 12 and 18 months later. The sample consisted of 94 patients with first-ever stroke. PSD was measured with the Beck Depression Inventory II. Repeated measures analysis of variance was used to evaluate the course of depressive symptoms over time and in relation to demographic and clinical variables. Results: Depression levels were stable during the 18 months after first-ever stroke. However, depression scores were significantly higher among patients who had lower physical functioning in the acute phase, were living alone or were not employed at the time of stroke. Conclusions: Several demographic and acute phase factors were associated with a more severe PSD course following stroke. Psychosocial support that begins in the acute phase and continues throughout the rehabilitation process may be helpful in improving both physical and psychological outcomes following stroke.

Implications for Rehabilitation

• Depression levels are stable during the first 18 months after first-ever stroke.

• The course of post-stroke depression is related to the level of physical functioning in the acute phase, whether the stroke survivors live alone and their employment status at the time of stroke.

• Psychological support that begins in the acute phase and continues throughout the rehabilitation process may be helpful in improving both physical and psychological outcomes following stroke.

• Depression
• employment
• physical impairment
• stroke

Acknowledgements

This article is based on the Post-stroke Fatigue study led by project director Dr Hesook Suzie Kim and principal researchers Drs Grethe Eilertsen, A.L. and Heidi Ormstad. We acknowledge the support and assistance provided by research fellow Linda N. Bakken, research assistant Gunn Pedersen and various staff members of Buskerud Hospital Trust in Drammen and Oslo University Hospital–Aker in Oslo, Norway.

Declaration of interest

This project was funded by the Research Council of Norway and Buskerud University College from 2006 to 2010 (grant 176503). A.L. has received funding from the RCN (grant 19256), the Norwegian Nurses Organization and the U.S.–Norway Fulbright Foundation. The authors report no other interests.